Ballot Question 2 seeks to improve dental care

Maine could lose its standing as the New England state with the highest percentage of toothless residents if supporters of a $5 million bond issue on the November ballot get their way. While organized opposition to the measure has not materialized, there is some question as to whether Maine voters are in the mood to endorse state borrowing, and one public health expert says dentists need concrete financial incentives to locate here.

Question 2 on the ballot will ask voters to approve state borrowing of $3.5 million to help pay for a new, $10 million teaching clinic for students of a proposed dental school at the University of New England, which has campuses in Biddeford and Portland. Another $1.5 million would be spent on upgrading facilities and equipment and expanding capacity at existing nonprofit dental health clinics throughout the state.

Both pieces of funding would be administered in an open bidding process. UNE is a likely contender for the teaching clinic, although other colleges and universities may also bid. Nonprofit clinics also would bid for awards to improve their facilities and equipment.

Advocates for Question 2 are kicking off a statewide campaign today.

Kneka Smith, associate dean for planning at UNE, said Monday that the dental school will cost a total of $20 million to get up and running and is already on track to admit its first class of students in 2012. The program will place fourth-year students in community internships at nonprofit dental clinics throughout the state, where they will provide comprehensive dental services for children and adults under the supervision of a licensed dentist, she said.

The long-term goal of the program, Smith said, is to increase the number of dentists who are committed to living and practicing in rural Maine communities.

“We are looking to turn out graduates who will be leaders in community health, public education and clinical excellence,” she said.

In a recent survey published by the World Health Organization, 42.9 percent of adults in West Virginia 2004 had no teeth, compared to 24.3 percent in Maine. But Maine’s rate was highest among New England states, trailed by New Hampshire at 21.1 percent.

According to the Rev. Bob Carlson, president of Penobscot Community Health Care in Bangor, Maine has one dentist for every 2,300 residents, compared to the national 1:1,600 ratio. The shortage is especially acute in the northern and more rural sections of the state. PCHC, classified as a “federally qualified health center,” operates sliding-scale dental clinics in Bangor and Old Town and expects to provide about 38,000 dental visits this year, Carlson said. There is still unmet need in the Bangor area, and farther afield, the demand for services is even greater, he said.

In addition to PCHC, there are 18 other federally qualified health centers in Maine, most in rural areas. Only 12 provide dental care. All would be eligible to apply for funding to create or expand dental services and host dental interns, Carlson said. In addition, a few other nonprofit dental clinics in Maine would be eligible to bid.

All three of Maine’s gubernatorial frontrunners endorse the measure, as do a number of medical and public health groups in Maine. At the University of Maine at Farmington, political science professor Jim Melcher said Maine voters rarely turn down bond issues. But this year, he said, with the state and national economies struggling, there is a growing call for fiscally conservative policies.

Melcher said many Maine voters will be surprised to find the dental school bond issue on the ballot and will not have thought through their response before voting on it.

“I predict it will win,” he said, “but it may not be easy.”

Pediatric dentist and public health advocate Jonathan Shenkin of Augusta, immediate past president of the Maine Dental Association, said Monday that developing a dental school at UNE and placing dental interns in rural clinics will do little long term to ease Mainers’ access to dental care.

The real problem, he said, is Mainers’ inability to pay for even discounted dental services.

“If people can’t pay for their care, you can’t force [dentists] to show up here with $350,000 in dental school debt and try to make a living,” he said. The state would do better to develop tax incentives and loan forgiveness programs to attract dentists to specific communities, he said.

The other bond issue on the ballot would allow the state to borrow $9.7 million for the Land for Maine’s Future program, a measure Melcher predicts will enjoy a stronger margin of voter approval.

At UNE, Smith said she speaks regularly with potential dental school students from Maine who are interested in the program’s public health mission. Some private fundraising for the new dental school is already in place — more hinges on the outcome of the November vote, she said.